AIM: To compare long-term postoperative outcomes of manual and femtosecond assisted corneal trephination in deep anterior lamellar keratoplasty(FS-DALK) for keratoconus.METHODS: In the retrospective study, 17 consecut...AIM: To compare long-term postoperative outcomes of manual and femtosecond assisted corneal trephination in deep anterior lamellar keratoplasty(FS-DALK) for keratoconus.METHODS: In the retrospective study, 17 consecutive eyes that underwent vertical side cut incision FS-DALK and 22 eyes that underwent trephine incision DALK were collected over a 2-year period. Main measurements included postoperative uncorrected-visual acuity(UCVA), corrected distance visual acuity(CDVA), refractive sphere and cylinder, manifest refraction spherical equivalent(MRSE), flat and steep corneal keratometry(K1 and K2), endothelial cell density(ECD), and time of epithelium healing and suture removal.RESULTS: Groups were comparable for diagnosis and preoperative visual acuity. Follow-up averaged 23 mo(range, 12-36 mo). At 12 mo, the mean UCVA was better in the manual-DALK group(P=0.039), and the refractive sphere was lower in the FS-DALK group(P=0.040). MRSE between groups differed at 1, 6, and 12 mo postoperatively(P=0.047, 0.025, 0.042, respectively). Mean CDVA, cylinder, K1, K2,corneal astigmatism, ECD, and time of epithelium healing were similar between groups. Stability of MRSE, ECD, and K1 returned sooner after FS-DALK. Initial loosened suture removal time was earlier in the manual-DALK group(P=0.042) while complete suture removal time was similar(P=0.122).CONCLUSION: Manual and femtosecond assisted corneal trephination in DALK are options for advanced keratoconus. FS-DALK do not result in improved visual acuity but it is more stable during the follow-up period. FSDALK in the present form show limited benefit, so surgical design and parameters still need to be optimized and explored.展开更多
A new approach is presented to reveal the temporal structure of femtosecond laser pulses by recording the correspond- ing time-resolved shadowgraphs of the laser-induced air plasma. It is shown that the temporal struc...A new approach is presented to reveal the temporal structure of femtosecond laser pulses by recording the correspond- ing time-resolved shadowgraphs of the laser-induced air plasma. It is shown that the temporal structures of femtosecond laser pulses, normally not observable by the ordinary intensity autocorrelator, can be detected through intuitively analyz- ing the ultrafast evolution process of the air plasma induced by the femtosecond laser pulses under examination. With this method, existence of pre- and post-pulses has been clearly unveiled within the time window of 4-150 fs in reference with the main 50-fs laser pulses output from a commercial 1-kHz femtosecond laser amplifier. The unique advantage of the proposed method is that it can directly provide valuable information about the pulse temporal structures＇ effect on the laser-induced ionization or material ablation.展开更多
基金Supported by the Innovation Project of Shandong Academy of Medical Sciences。
文摘AIM: To compare long-term postoperative outcomes of manual and femtosecond assisted corneal trephination in deep anterior lamellar keratoplasty(FS-DALK) for keratoconus.METHODS: In the retrospective study, 17 consecutive eyes that underwent vertical side cut incision FS-DALK and 22 eyes that underwent trephine incision DALK were collected over a 2-year period. Main measurements included postoperative uncorrected-visual acuity(UCVA), corrected distance visual acuity(CDVA), refractive sphere and cylinder, manifest refraction spherical equivalent(MRSE), flat and steep corneal keratometry(K1 and K2), endothelial cell density(ECD), and time of epithelium healing and suture removal.RESULTS: Groups were comparable for diagnosis and preoperative visual acuity. Follow-up averaged 23 mo(range, 12-36 mo). At 12 mo, the mean UCVA was better in the manual-DALK group(P=0.039), and the refractive sphere was lower in the FS-DALK group(P=0.040). MRSE between groups differed at 1, 6, and 12 mo postoperatively(P=0.047, 0.025, 0.042, respectively). Mean CDVA, cylinder, K1, K2,corneal astigmatism, ECD, and time of epithelium healing were similar between groups. Stability of MRSE, ECD, and K1 returned sooner after FS-DALK. Initial loosened suture removal time was earlier in the manual-DALK group(P=0.042) while complete suture removal time was similar(P=0.122).CONCLUSION: Manual and femtosecond assisted corneal trephination in DALK are options for advanced keratoconus. FS-DALK do not result in improved visual acuity but it is more stable during the follow-up period. FSDALK in the present form show limited benefit, so surgical design and parameters still need to be optimized and explored.
基金Project supported by the National Natural Science Foundation of China (Grant Nos. 11004111 and 61137001)the Natural Science Foundation of Tianjin City,China (Grant No. 10JCZDGX35100)+1 种基金the Specialized Research Fund for the Doctoral Program of Higher Education of China (Grant No. 20100031120034)the Fundamental Research Funds for the Central Universities of China
文摘A new approach is presented to reveal the temporal structure of femtosecond laser pulses by recording the correspond- ing time-resolved shadowgraphs of the laser-induced air plasma. It is shown that the temporal structures of femtosecond laser pulses, normally not observable by the ordinary intensity autocorrelator, can be detected through intuitively analyz- ing the ultrafast evolution process of the air plasma induced by the femtosecond laser pulses under examination. With this method, existence of pre- and post-pulses has been clearly unveiled within the time window of 4-150 fs in reference with the main 50-fs laser pulses output from a commercial 1-kHz femtosecond laser amplifier. The unique advantage of the proposed method is that it can directly provide valuable information about the pulse temporal structures＇ effect on the laser-induced ionization or material ablation.
